My back is killing me. What can I do?

Back pain in pregnancy is almost universal. The bigger the belly, the more curved the spine, and the worse the back pain. As your center of gravity moves forward with your ever increasing belly size, your hips rotate forward, the curvature of your back changes, and the muscle groups you use to maintain your posture change. Because you are not used to using these muscle groups to stay upright, and because all of your muscles are doing more work than normal carrying around the extra weight, the result is chronic muscle strain, sprain, and fatigue.

Things to try include using acetaminophen to treat the pain and if you are less than 20 weeks’ gestation, you can still use nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen or Naprosyn occasionally. A heating pad on the back, heat releasing patches, or a nice bath may also help a lot.

Exercise can help tremendously. Gymnasts and ballet dancers rarely complain of back pain during pregnancy because they have well-developed back musculature and core abdominal muscles. Exercises that help strengthen the back and core abdominal muscles can provide relief and prevent worsening problems as the pregnancy goes on. This includes things like Pilates or Yoga.

Many women benefit from wearing a back brace or pregnancy support belt (belly band). These devices tend to change your center of gravity slightly and help redistribute the load. Typically, these are most helpful in the third trimester. Even if you did not need one in your first pregnancy, keep in mind that during your second or third pregnancy you carry the baby differently in your pelvis and it may be beneficial this time around.

Massage can be beneficial and some women may need help from a physical therapist. Your doctor can let you know if physical therapy or, in some cases, pelvic floor physical therapy, might be appropriate for your symptoms. In some cases, we may prescribe muscle relaxants but these tend to be sedating. Still, they can be useful at night.

It’s unusual for back pain during pregnancy to require any testing or other treatments. However, if you have a history of chronic back pain or orthopedic abnormalities, be sure to tell your doctor or midwife. Various pains, particularly back pain, pelvic pain, and round ligament pain, are common in pregnancy.

Here is a list of things that can help relieve pains:

  • Stretch and do strengthening exercises like Pilates or Yoga
  • Wear a pregnancy support belt
  • Use Tylenol
  • Use warm compresses or pads
  • Wear low-heeled shoes with good arch support
  • Avoid lifting heavy items by yourself
  • Elevate one foot on a support if you must stand for a long period of time
  • Bend with your knees, not at the waist
  • Try to sleep on your side with one or two pillows between your knees
  • Place a board under your mattress to make your bed firmer

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